If you’ve been unable to conceive within a long period of time, seek help from your doctor for evaluation and treatment of infertility.
An at-home, over-the-counter ovulation prediction kit detects the surge in luteinizing hormone (LH) that occurs before ovulation. A blood test for progesterone — a hormone produced after ovulation — can also document that you’re ovulating. Other hormone levels, such as prolactin, also may be checked.
When a woman is not ovulating by herself then ovulation induction may be required. The most common causes of failure to ovulate are stress, weight fluctuations and Polycystic Ovarian Syndrome (PCOS). Other causes may include disorders of the pituitary gland, thyroid gland and raised prolactin levels. In some cases failure of ovulation is due to ovarian failure. This may occur following treatment for cancer or may be the start of the menopause – premature ovarian failure.
If a woman has an irregular menstrual cycle, monitoring with ultrasound scans (follicle tracking) and hormone assessments may help to identify the fertile time of the month and so improve the chances of natural conception.
Before ovulation problems can be treated it is important to undertake certain tests to establish the cause. These tests include an ultrasound scan of the ovaries and womb and blood tests to measure a range of hormones including thyroid, prolactin, FSH, LH, Testosterone and other androgens (male hormones). It is also important to ensure that the ovary is capable of responding to the drug treatment. One possible cause of failed ovulation is ovarian failure more commonly known as the menopause. If the FSH (> 10) concentration level is high and the AMH concentration is low when measured at the start of a period, ovarian failure is likely. In such cases fertility treatment is less successful.
If ovulation does not occur, then medications may be administered with the onset of menstruation to stimulate egg production. If tablets are not effective then more powerful fertility injections may be necessary to stimulate egg production in the ovaries.